CLOSE
Arts & Entertainment

by -
0 247

Reviewed by Jeffrey Sanzel

Cynthia Baxter, one of our most prolific and delightful cozy mystery writers, has outdone herself with her most recent offering, a delicious confection titled “Murder with a Cherry On Top.”

Cynthia Baxter

As a longtime fan of Baxter’s work, I have read many of her books, most notably ones in the Reigning Cats & Dogs series (“Dead Canaries Don’t Sing,” “Hare Today, Dead Tomorrow,” “Who’s Kitten Who?” and “Murder Had a Little Lamb”), Murder Packs a Suitcase series (“Murder Packs a Suitcase”), as well as “Temptation,” a fascinating and wicked stand-alone novel (written as Cynthia Blair). They are all truly entertaining works, with fun and engaging heroines who are smart, independent and wholly original.

In her latest outing, “Murder with a Cherry On Top,” the Three Village resident sets us down in the fictional Wolfert’s Roost, a small town nestled in the Hudson Valley. Here, the central character, 33-year-old Kate McCay, has come back to her hometown. Prior to this, Kate had been a public relations director at a large New York City firm. Returning to take care of her beloved grandmother, she has embarked on a new venture, namely being proprietress of the Lickety Splits Ice Cream Shoppe:

“After all, there are some things only ice cream can fix.”

Her love for the dessert is rooted in her childhood. She has memories of her father taking her for her third and fourth birthdays for ice cream. By her fifth, he had passed away. When she is 10, her mother dies, leaving Kate and her sisters to live with their loving grandmother:

“Then Mom passed away the summer I turned ten. Grams suddenly found herself playing the role of mother. She knew how devastated my sisters and I were, and to help us all cope with our confusion, our anger, and our intense feelings of loneliness, she did her best to keep our lives as much the same as they had been before. A big part of that was to keep our family ice cream addiction going, since it was one of the easiest and most obvious ways of linking us to the past and moving ahead with our lives.”

In Kate’s world, ice cream is deeply connected to love and caring and she brings this to her new found vocation. She delights in the work, creating the traditional flavors along with signature choices such as Peanut on the Playground (laced with jelly), Honey Lavender and Avocado and Carrot Cake. (The detours describing her frozen sweets add to the fun.)

After being open only a week, her childhood nemesis and unreformed mean girl, bakery owner Ashley Winthrop, announces that her store, Sweet Things, will begin carrying ice cream. As the bakery is directly across from the ice cream parlor, this drives Kate into a public confrontation with Ashley. Soon after, Ashley is discovered murdered and the police see Kate as a possible suspect.

Kate embarks on her own investigation, which has some wonderful twists and turns, building up to a genuinely surprising but nonetheless believable climax. At its height, the mystery becomes something deeper and eventually much more complex.

An element of the book that is particularly effective is that Kate actually uses her business to solve the crime. Unlike in many mysteries where the characters seem to have insights they couldn’t possibly have, here there is logic to her approach. She utilizes her occupation to provide her with insight as well as opportunity. She cleverly uses the collective love of ice cream as a means to certain ends. And, even as she is pursuing leads, she still is thinking about the growth of her new undertaking.

In a light-hearted way, Baxter addresses the issue of not just the difficulty in returning home but also the joys — rare in literature, which tends to fixate on dysfunction. Kate is genuinely glad to be back and wholly embraces the chapter ahead of her. She finds satisfaction in her work, a passion and a drive that help her reacclimate to Wolfert’s Roost.

The fact is Baxter is a strong writer. Throughout, she is able to articulate the modern struggle to communicate with wit and honesty:

“I wondered how any of us managed to not look bored or lonely or even uncomfortable in public places before we all had cell phones. Maybe that was why books had been invented.”

Baxter nimbly fleshes out characters who are (or at least initially seem to be) transitory. They are whole people, often created in a few crisp sentences. This is ideal in a mystery where there is the need for a parade of suspects and supporting characters.

We get to know Willow, her childhood friend, who works for her when she’s not teaching yoga. Emma, Kate’s in-search-of-herself 18-year-old niece, comes to live with her and assists in the investigation. Ashley’s sleazy ex-husband and her most recent amour, an egotistical chef, both get creative page time. Kate’s love interest, blue-eyed broad-shouldered Jake Pratt, has a past with Kate that becomes pivotal in the present — but the thorny history never bogs down the movement of the narrative. A visit to a harried mother of three is particularly vivid.

Baxter finds variety even in the rather reviled murder victim as certain pieces of her backstory are revealed, transitioning from the “she-had-it-coming” to something far more complicated. The fact that Ashley is running an illegal co-op becomes a fascinating detail in the tapestry of the crime.

All of these pieces, like the exotic sundaes Kate fashions, are rich in texture, color and invention and make for a wholly satisfying read.

Two nice little bonuses: Each chapter is headed with a “fun fact” from the history of ice cream, with sources ranging from Guinness to the International Dairy Foods Association. The appendix shares a few interesting recipes that are referenced in the book.

This first entry into The Lickety Splits Ice Cream Shoppe Mystery series is a great one. Grab yourself a bowl of ice cream, sit down and dig in.

Cynthia Baxter is the author of 54 novels. A Three Village resident for the past 25 years, “Murder with a Cherry On Top” is the first book in her new Lickety Splits Ice Cream Shoppe Mystery series with Kensington Publishing Corp. and is available online at Barnes & Noble and Amazon. Meet Cynthia at the Emma S. Clark Library’s Author Event on May 6 from 1:30 to 3:30 p.m. and visit her website at www.cynthiabaxter.com.

by -
0 1431
The flowering plant Amborella trichopoda is the oldest ancestral form of the angiosperms .

By Elof Axel Carlson

Elof Axel Carlson

Flowering plants are familiar to us as bouquets and garden plantings that delight us as they emerge in spring and summer. They are collectively part of the angiosperms, which also include familiar trees with generous-sized leaves that are shed in the fall.

They first appear in the fossil record about 130 million years ago. For those not familiar with how old life on Earth is estimated to be by biologists, that is about 60 million years before the dinosaurs went extinct.

Ferns, mosses and conifer trees (like gingkoes) existed long before the angiosperms. If the angiosperms are arranged in a sequence from oldest to most recent types, the oldest ancestral form of the angiosperms alive today is found in the Pacific Ocean on New Caledonia, an island northeast of Australia and northwest of New Zealand. That flowering plant is known as Amborella trichopoda.

A lot has been learned about the biology and history of Amborella. Its pollen, or ovule, has 13 chromosomes (and thus its leaf, stem and root cells have 26 chromosomes each). The Amborella ancestor gave rise to 250,000 species of flowering plants. About 75 percent of them have seeds with two fleshy modified leaves called cotyledons.

If you eat a fresh green pea from a pod and look at it before you pop it into your mouth, it has two halves, which is why you call it split pea soup when you cook a bag of dried peas.

The flower of the Amborella trichopoda

The DNA of Amborella has been worked out. It has 870 million base pairs. These are organized as 25,347 genes. Shortly before Amborella arose, it had experienced a doubling of its chromosome number. No major changes have occurred in its chromosomes since that event. Its nuclear genes have few inserted repetitive sequences. But, curiously, its mitochondrial DNA has many horizontally transferred genes from algae, mosses and lichens.

The ancestral genome of the angiosperms can be inferred because the major branches of the angiosperms share that core set of genes. This will allow botanists and chemists studying plant evolution to work out the functions of these shared genes as well as the distinctive genes that gave rise to the six major branches of flowering plants.

Quite different is the loblolly pine. It is a gymnosperm rather than angiosperm. They have a much longer history on Earth than the angiosperms. The conifers are the most familiar of the gymnosperms whose seeds are “naked” and enclosed in cones. Imagine the pine cones used in foods and compare them to the peas and beans in your soups.

The loblolly pine can live up to 300 years.

The loblolly pine, or Pinus taeda, is a common pine tree found from Florida to Texas and as far north as New Jersey. The trees can live 300 years and they are a major source of industrial lumber and paper pulp. The name loblolly is from an English idiom for food boiled in pots producing soups, broths or porridges. It has the largest known genome of any living organism, 23.2 billion base pairs (about seven times more than human cells and about 22 times that of Amborella. Unlike Amborella, 82 percent of its DNA is repetitive (formerly called junk DNA) caused by infectious insertions of tiny sequences of DNA. It has 50,172 genes in its pollen, or ovule, genome and they are located in 12 chromosomes per gamete.

One of my six students who got their doctorates with me at UCLA, Ronald Sederoff, pioneered the molecular biology of woody plants using the loblolly pine. He devised a technique to insert genes into woody plants, enabling his laboratory to study how wood is formed and how genes could be studied without waiting many years to study their genetics.

I was very pleased to learn that he was the recipient of the Wallenberg Prize, which is given by the king of Sweden for a contribution to plant biology, a field that is usually overlooked in the Nobel physiology and medicine prize. He attended the ceremony in Stockholm last October.

Elof Axel Carlson is a distinguished teaching professor emeritus in the Department of Biochemistry and Cell Biology at Stony Brook University.

by -
0 429
The cast of 'The Wizard of Oz'. Photo courtesy of Engeman Theater
Dorothy and friends delight audiences at the Engeman

By Rita J. Egan

The John W. Engeman Theater closes out its 2017-2018 Children’s Theater with a charming version of the cherished children’s tale, “The Wizard of Oz.” The Northport venue debuted the musical on March 24, and Suzie Dunn has done an excellent job directing the eight adult actors down the yellow brick road.

Based on the children’s books by L. Frank Baum, “The Wizard of Oz” tells the story of young Dorothy Gale and her dog Toto. When a tornado sweeps Dorothy away from her home in Kansas and over the rainbow to a magical land, she meets witches, Munchkins and three charming travel companions. While the Engeman’s “Wizard” is an abridged version of the story — no poppies and less of the witch’s monkeys and guards — all the favorite characters and songs from the 1939 MGM Studios motion picture are present.

Danielle Aliotta’s portrayal of Dorothy is as endearing as Judy Garland’s was in the movie, and the actress sings a sweet “Somewhere Over the Rainbow” with strong, clear vocals.

 

Jacqueline Hughes and Danielle Aliotta in a scene from ‘The Wizard of Oz.’ Photo by Jennifer Tully

Her companions down the yellow brick road are just as delightful. Jacqueline Hughes (Scarecrow), Danny Meglio (Tin Man) and Andrew McCluskey (Cowardly Lion) do fantastic jobs during their respective numbers, “If I Only Had a Brain,” “If I Only Had a Heart” and “If I Only Had the Nerve.” McCluskey’s vocals are also wonderful during his solo “If I Were King of the Forest.”

Maeve Barth-Dwyer has perfected the evil shrill voice of the Wicked Witch, and Antoine Jones plays the Wizard of Oz and the Emerald City doorman with just the right amount of quirkiness. Marielle Greguski is lovely as both Glinda and Auntie Em and sings beautifully with Aliotta on the reprise of “Somewhere Over the Rainbow.”

With no poppies to put Dorothy and friends to sleep, the witch tries to undermine their mission with the help of a tap dancing jitterbug played by Marquez Catherine Stewart, an upbeat number that was cut from the original motion picture to shorten it. While the song and dance routine may not have been fitting for the perilous journey in the movie, it is perfect for a live production for children. Stewart, Aliotta, Hughes, Meglio and McCluskey do a fantastic job with this refreshing number.

Danielle Aliotta, Danny Meglio and Jacqueline Hughes in a scene from ‘The Wizard of Oz.’ Photo by Jennifer Tully

Young audience members at the Sunday show were thrilled to see the actors walk through the aisles while they were on their way to the Emerald City to see the Wizard. Costume designer Jess Costagliola has done a wonderful job replicating the character’s costumes, especially Glinda’s pretty pink gown, and a few of the actors dressed in giant hats with big googly eyes are adorable as the Munchkins.

Sponsored by Bethpage Federal Credit Union, the Engeman’s “The Wizard of Oz” is a special treat for audience members of all ages, and a wonderful tribute to a nearly 80-year-old classic that proves there’s no place like home. Running time is 90 minutes with one 15-minute intermission, booster seats are available and children can meet the cast in the lobby after the show for photos and autographs. (An autograph page is included at the back of the program.)

The John W. Engeman Theater, located at 250 Main St., Northport, presents “The Wizard of Oz” through April 29. Children’s Theater returns for the 2018-2019 season with “Shrek The Musical” from July 28 to Sept. 2 followed by “The Little Mermaid Jr.” from Sept. 22 to Oct. 28, “Frosty” from Nov. 24 to Dec. 30, “Seussical The Musical” from Jan. 26 to March 3, 2018, and ends with “Madagascar: A Musical Adventure” from March 23 to April 28. All seats are $15. For more information, call 631-261-2900 or visit www.engemantheater.com.

by -
0 1782
A view of Northport Harbor and Estate boathouse from the Vanderbilt Museum’s rose garden. Photo courtesy of Vanderbilt Museum

The Suffolk County Vanderbilt Museum, located at 180 Little Neck Road in Centerport, will host its first Gardeners Showcase, “Bringing Back the Gardens,” during the spring and summer of this year. The museum invites local nurseries and garden designers to show off their skills and creativity in one of the gardens that grace the 43-acre waterfront estate, which is listed on the National Register of Historic Places. Spots are available for nine showcases, and will be available on a first-come, first-served basis.

In return for their effort and contribution, participants will receive:

* Signage that identifies their business at each garden showcase site. This signage will be viewed by the more than 100,000 anticipated Vanderbilt visitors during the spring, summer and fall.

* Recognition on the Vanderbilt website and publicity on its social-media platforms (Facebook, Twitter and Instagram).

* Publicity through news releases sent to regional media including Newsday, News12, Patch, and Long Island weekly newspapers.

* A one-year, Associate Membership to the Vanderbilt Museum.

To secure a spot in this year’s Gardeners Showcase, or to obtain more information, please contact Jim Munson, the Vanderbilt Museum’s operations supervisor, at 631-379-2237 or at [email protected].

by -
0 184
WMHO to host 6th annual talent show contest

Attention Long Island students! Can you carry a tune? Or is a musical instrument your specialty? If so, get your audition DVD or YouTube video submitted now for Long Island’s Got Talent 2018, hosted by the Ward Melville Heritage Organization (WMHO). Created by WMHO’s Youth Corps, the event gives Long Island students the opportunity to showcase their talents this spring.

The competition is open to students 10 to 17 years of age in Nassau or Suffolk County who must still be in high school at the time final awards are given in October of this year. Talent must be non-professional vocal or musical instrument performances. The entry deadline is April 6 and there is a $25 entry fee. Those who are contacted after submitting their audition will be asked to perform at the first round competition on Saturday, April 14 at 2 p.m. at WMHO’s Educational & Cultural Center, 97P Main Street in the Stony Brook Village Center. Finalists chosen will also be given the opportunity to perform at WMHO’s Sunday Summer Concerts series in July and August.

For full details and Official Entry Form, call 631-751-2244 or visit www.stonybrookvillage.com/what-to-do-events/.

by -
0 1851
Julia's Chocolate Chiffon Cake

By Barbara Beltrami

Last week I wrote about spring holiday meals and how much in common there is among the cuisines of various religions. From tender young vegetables to lots of eggs as decorations or ingredients, to light, fluffy desserts, everything seems to converge on the spring theme. Last week I also promised to give you a few recipes for those light-as-a-feather cakes that, whether angel food, sponge or chiffon, rely heavily on egg whites.

Spring-y and delicate, none are difficult to make. All of them make beautiful presentations, especially if decorated with seasonal pastels or confections and all of them function beautifully as complements to fruits, sauces, ice cream and sorbets. So tie on your apron, heat up that oven, get out your electric mixer and cake pans, take those eggs out of the refrigerator and let’s bake!

Julia’s Chocolate Chiffon Cake

Julia’s Chocolate Chiffon Cake

YIELD: Makes 8 to 12 servings

INGREDIENTS:

¾ cup boiling water

½ cup cocoa

1¾ cups cake flour

1¾ cups sugar

1½ teaspoons baking soda

1 teaspoon salt

½ cup vegetable oil

7 unbeaten egg yolks

2 teaspoons vanilla extract

7 egg whites

½ teaspoon cream of tartar

DIRECTIONS: Preheat oven to 325 F. Combine boiling water and cocoa; let cool. Sift together flour, sugar, baking soda and salt. Make a well in the center, then add oil, egg yolks, vanilla and cocoa mixture, and beat until smooth. Put egg whites and cream of tartar into large mixing bowl and beat until stiff peaks form. Pour egg yolk mixture in thin stream over entire surface of egg whites. With rubber spatula gently fold in until well blended. Pour into ungreased 10-inch tube pan. Bake 55 minutes, then raise heat to 350 F and bake another 10 to 15 minutes. Remove from oven; invert onto wire rack until cool. Remove from pan and decorate with your favorite frosting, if desired. Otherwise, serve with fudge sauce, whipped cream, liqueur or vanilla or chocolate ice cream.

Nana’s Orange Sponge Cake

Nana’s Orange Sponge Cake

YIELD: Makes 8 to 10 servings

INGREDIENTS:

6 eggs, separated

1/8 teaspoon salt

1 cup sugar

¼ cup freshly squeezed orange juice

½ cup Passover cake meal

¼ cup potato starch

Freshly grated rind of half an orange

DIRECTIONS: Preheat oven to 350 F. In a small bowl beat the egg whites and salt until soft peaks form. In another larger bowl combine the egg yolks, sugar and orange juice and beat until frothy and pale. In a third bowl combine the cake meal and potato starch and gradually beat into the egg yolk mixture until batter is smooth. Fold in the egg whites and orange rind. Transfer batter to an ungreased tube pan with a removable bottom and bake for one hour. Remove from oven and invert over wire rack until cool. Unmold and serve with orange sorbet, stewed fruit or fresh berries.

Rebecca’s Angel Food Cake

Rebecca’s Angel Food Cake

YIELD: Makes 8 to 10 servings

INGREDIENTS:

8 egg whites

¼ teaspoon salt

1 teaspoon cream of tartar

½ teaspoon almond extract

1 teaspoon vanilla extract

1¼ cups fine granulated sugar

1 cup cake flour

DIRECTIONS: Preheat oven to 325 F. Dust a 10-inch tube pan with flour but do not butter it. Beat egg whites with salt until foamy; add cream of tartar and continue beating until egg whites form soft peaks. Add almond and vanilla extracts; lightly stir once. Sift together the sugar and cake flour over a separate bowl; repeat three times. Using a whisk or spatula, gently fold the sifted mixture, two tablespoons at a time, into the beaten egg whites until the batter is completely blended. Spoon evenly into prepared tube pan. Bake for 50 minutes; turn the oven off and leave cake in for another 10 minutes. Turn cake upside down on a wire rack and let sit for one hour, then carefully unmold. Serve with chocolate sauce or pureed strawberries.

by -
0 211

MEET DUDLEY AND SHANIA!

This week’s shelter pets are the sweet duo of, from left, Dudley, a lab mix, and Shania, a shepherd mix. They had a tough start to life when they were abandoned together at a Virginia farm and now they are waiting for a new home at Kent Animal Shelter.

These 4-year-old cuties truly are the best of friends and bring out the best personalities in each other. They have so much love to give to anyone willing to give them a chance! Hopefully Dudley and Shania can be adopted together but either way they are both looking for a great home. They come neutered/spayed, microchipped and up to date on all their vaccines.

Kent Animal Shelter is located at 2259 River Road in Calverton. The adoption center is open from 10 a.m. to 4 p.m. every day. For more information on Dudley, Shania and other adoptable pets at Kent, visit www.kentanimalshelter.com or call 631-727-5731.

*Update 10/5/18: Dudley and Shania have been adopted together! Happy life you two!

by -
0 616
1 of 17
Donna and the Dynamos put on a show the night before Sophie’s wedding.
Michelle Rubino as Sophie
Christina D'Orta as Donna
'Voulez-Vous'
'Chiquitita'
Mark Cahill (Harry) and Christine D'Orta
Donna and the Dynamos
Andrea Galeno (Rosie) and Michael Bertolini (Bill)
Christina D'Orta (Donna) and Steve Corbellini (Sam)
Stephanie Moreau (Tanya)
The cast of 'Mamma Mia!'
The three 'dads' - Sam, Bill and Harry
Reading of the diary
A scene from 'Mamma Mia!'
A scene from 'Mamma Mia!'
Michelle Rubino (Sophie) and Niko Touros (Sky)
Donna and the Dynamos

By Heidi Sutton

“Mamma Mia!” has had quite a run so far and shows no sign of slowing down. The jukebox musical, based around the music of Swedish pop group ABBA, was a 14-year-long hit on Broadway. When it closed in 2015, it earned the title as the eighth longest-running show in Broadway history. The show was adapted for the big screen in 2008 with a sequel titled “Mamma Mia! Here I Go Again” set to be released this July. Now the smash hit arrives at the Smithtown Center for the Performing Arts and does not disappoint.

Written by Catherine Johnson, with music and lyrics by former ABBA members Benny Andersson and Björn Ulvaeus, as well as some songs with Stig Anderson, “Mamma Mia!” tells the story of 20-year-old Sophie (Michelle Rubino) who has grown up on a small Greek island with her single mother, Donna, who runs a taverna.

Sophie is getting married to her fiancé Sky (Niko Touros) and wants to have her father walk her down the aisle. The problem is that she doesn’t know who that is! Her mother (Christina D’Orta), the former lead singer of the 1970s pop group Donna and the Dynamos, refuses to talk about the past, so Sophie decides to take matters into her own hands. “I want to get married knowing who I am.”

After reading her mother’s diary, she narrows the possibilities down to three men, the Australian adventurer Bill (Michael Bertolini), the debonair architect Sam (Steve Corbellini) and London banker Harry (Mark Cahill) and secretly invites them to the wedding. When all three show up, Sophie turns detective to try to find her real father. When the “dads” start to figure things out (“This is beginning to look like a set up …”) all three offer to give Sophie away, and confusion and mayhem ensues.

Donna, on the other hand, is forced to reconnect with her past and face her demons, especially with Sam who she thinks cheated on her. Fortunately, she has invited her two lifelong girlfriends and former band members, Tanya (Stephanie Moreau) and Rosie (Andrea Galeno) to the wedding who help her get through it with tears and laughter.

I remember seeing the show on Broadway at the Winter Garden Theater years ago and, except for the encore, did not enjoy it. Seeing it again last Sunday in the balcony of this quaint community theater on Smithtown’s Main Street has renewed my faith. Why? Let me count the ways.

The level of professionalism: Tommy Ranieri directs an incredibly talented cast of 20 who clearly love what they are doing. All the actors fit perfectly in their roles, especially evident in the chemistry between D’Orta and Corbellini and Rubino and Touros.

The feel-good music: The show features such classic hits as “Dancing Queen,” “Money, Money, Money,” “Super Trouper,” “Mamma Mia,” “The Name of the Game” “Voulez-Vouz,” “The Winner Takes it All,” “Honey, Honey,” “Chiquitita,” “Gimmie, Gimmie, Gimmie” and “S.O.S” to name a few.

The singing: Where to begin? This ABBA songfest takes viewers on an emotional rollercoaster with one musical number after another. Donna’s solo, “Slipping Through My Fingers,” is lovely and heartfelt and Tanya’s sexy number, “Does Your Mother Know,” is an audience favorite. Rosie and Bill’s duet, “Take A Chance on Me,” is hilarious and Donna and Sam’s duet, “S.O.S,” is heartwrenching.

The choreography: The musical numbers, choreographed by Danielle Nigro, are superb, especially during “Voulez-Vous” where the dancers flop around in wet suits and flippers in perfect rhythm — not an easy feat.

The impeccable costumes: Costume design by Ronald Green III is on point, ranging from fun beach garb to wedding attire to the flashy 1970s dance costumes in the finale where even the men wear heels.

The clever set: Designed by Timothy Golebiewski, the set features classic white walls that swivel back and forth, revealing a beachfront restaurant with a fully stocked bar and bar stools on one side and a bedroom on the other. The background features images of palm trees and clouds with soft hues of blues and pinks.

The encore: Cast members come down into the aisles and, with very little nudging, invite the audience to join them in dancing, clapping and singing to a remix of “Mamma Mia,” “Dancing Queen” and “Waterloo.”

If you love the songs of ABBA, go see this show. If you’ve seen “Mamma Mia!” on Broadway and loved it, go see this show. If you didn’t enjoy “Mamma Mia!” the first time around, go see this show and see it done right.

The Smithtown Center for the Performing Arts, located at 2 East Main Street, Smithtown will present “Mamma Mia!” through April 29. Running time is 2.5 hours with one 15 minute intermission. For mature audiences due to mild language and sexual content.

The season continues with “Dreamgirls” from May 12 to June 17; the northeastern regional premiere of “We Will Rock You,” a musical based on the songs of Queen, from July 7 to Aug. 19; and “Fun Home” from Sept. 8 to Oct. 21. Tickets are $38 adults, $34 seniors and $25 students. To order, call 631-724-3700 or visit www.smithtownpac.org.

All photos by James Gorman

by -
0 2471
Symptoms of gallstones include dull or crampy abdominal pain that is exacerbated by meals and lasts one to five hours. Stock photo

By David Dunaief, M.D.

Dr. David Dunaief

Gallstones are a very common gastrointestinal disease; they affect up to 20 million Americans between the ages of 20 and 74, with a more than two-times increased occurrence in women than in men, according to the NHANES III survey (1). There are two types of gallstones, 80 percent of which are cholesterol stones and 20 percent of which are pigment stones.

Common symptoms

Gallstones may be asymptomatic; however, when gallstones block either the cystic or common bile ducts, symptoms occur. Symptoms include dull or crampy abdominal pain that is exacerbated by meals and lasts one to five hours. Jaundice, which includes yellowing of skin and eyes, is another symptom. Others include nausea and vomiting, rapid heart rate, hypotension (low blood pressure) and fever (2).

Tests used for diagnosis

Blood tests include complete blood count, where there may be a rise in white blood cells; liver enzymes; and the pancreatic enzymes lipase and amylase. In general, diagnostic tests that have more accuracy are the endoscopic ultrasonography (EUS) and endoscopic retrograde cholangiopancreatography (ERCP). However, these are invasive tests. Less accurate but noninvasive tests include abdominal X-ray, ultrasound and CAT scan (CT). The tests used also depend on where the stone may be located. Hepatobiliary (HIDA) scans are accurate if the stone is located in the cystic duct. And magnetic resonance retrograde cholangiopancreatography (MRCP) is used if the stone is thought to be located in the common bile duct (2).

What are the risk factors?

There are a multitude of risk factors. Some of these are modifiable, some others are not. The modifiable ones include obesity, measured by body mass index (BMI); rapid weight loss; fat consumption; hormone replacement therapy (HRT); oral contraceptives; decreased physical activity; Crohn’s disease; and certain drugs. One nonmodifiable risk factor is age; the older we get, the higher the risk, with age 40 being the demarcation line (3). Other risk factors are gender, with females being more predisposed; pregnancy; and family history (4). Let’s look at the evidence.

Obesity risks

Obesity may play an important role. Obesity is not age discriminant; it can impact both adults and children. The reason obesity is implicated is potentially due to bile becoming supersaturated (5). Bile is a substance produced in the liver and stored in the gallbladder. Bile aids in the digestion or breakdown of fats in the small intestines. Crystals may form, creating cholesterol gallstones from the bile.

Body mass index

A body mass index of greater than 30 kg/m² is considered obese. In a meta-analysis of two prospective, forward-looking observational trials, Copenhagen General Population Study and the Copenhagen City Heart Study, those in the highest quintile of BMI were almost three times as likely to experience symptomatic gallstones compared to those who were in the lowest quintile (6). The highest quintile was those who had a mean BMI of 32.5 kg/m² and thus were obese, whereas those in the lowest quintile had a mean BMI of 20.9 kg/m². This is a comparison of ideal to obese BMI. Not surprisingly, since women in general have a higher risk of gallstones, they also have a higher risk when their BMI is in the obese range compared to men, a 3.36-fold increase and 1.51-fold increase, respectively.

Also, the research showed that for every 1 kg/m² increase in BMI, there was a 7 percent increase in the risk of gallstones. Those who had genetic variants that increased their likelihood of an elevated BMI had an even greater increase in gallstone risk —17 percent — per 1 kg/m². In the study population of approximately 77,000, more than 4,000 participants became symptomatic for gallstones.

Gallstones in children

Sadly, obese children are not immune to gallstones, even though they are young. In a prospective observational study based on Kaiser Permanente data from southern California, children who were overweight had a twofold increased risk of gallstones (7). But if that is not enough, girls who were extremely obese had a higher propensity for gallstones, similar to women in the previous study, with a greater-than-sevenfold increase compared to a still very substantial greater-than-threefold increase for obese boys. Hispanic children were affected the most. The age range in this study was between 10 and 19 years old. Obesity is a disease that is blind to age.

Physical activity

We know physical activity is very important to stave off many diseases, but in this case, the lack of physical activity can be detrimental. In the Physicians’ Health Study, a prospective observational trial, those in the lowest quintile of activity between the ages of 40 and 64 had a 72 percent increased risk of gallstone formation, and those 65 and older had a 33 percent increased risk (8). Also, men who were 65 and older and watched television more than six hours a week were at least three times as likely to have gallstones as those who watched fewer hours. There was a substantial increased risk for those under 65, as well, though to a slightly lesser degree.

Diabetes rears its ugly head

Just like with obesity, diabetes is almost always a culprit for complications. In a prospective observational study, those with diabetes were at a significant 2.55-times greater risk of developing gallstones than those without (9). Again, women had a higher propensity than men, but both had significant increases in the risk of gallstone formation, 3.85-times and 2.03-times, respectively. There were almost 700 participants in this study. The researchers believe that an alteration in glucose (sugar) metabolism may create this disease risk.

Hormone replacement therapy

If you needed another reason to be leery of hormone replacement therapy (HRT), then gallstones might be it. In a prospective observational trial, women who used HRT, compared to those who did not, had a 10 percent increased risk in cholecystectomy — removal of the gallbladder — to treat gallstones (10). Though this may not sound like a large increase, oral HRT increased the risk 16 percent, and oral estrogen-only therapy without progestogens increased the risk the most, 38 percent. Transdermal HRT did not have a significantly increased risk.

It is never too early or too late to treat obesity before it causes, in this case, gallstones. With a lack of exercise, obesity is exacerbated and, not surprisingly, so is symptomatic gallstone formation. Diabetes needs to be controlled to prevent complications. HRT, unless menopausal symptoms are unbearable, continues to show why it may not be a good choice. Next week, we will look at the complications of gallstones and how to prevent them.

References: (1) Gastroenterology. 1999;117:632. (2) emedicine.medscape.com. (3) J Hepatol. 1993;18 Suppl 1:S43. (4) uptodate.com. (5) Best Pract Res Clin Gastroenterol. 2014 Aug;28:623-635. (6) Hepatology. 2013 Dec;58:2133-2141. (7) J Pediatr Gastroenterol Nutr. 2012;55:328-333. (8) Ann Intern Med. 1998;128:417. (9) Hepatology. 1997;2:787. (10) CMAJ. 2013;16;185:549-550.

Dr. Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com or consult your personal physician.

by -
0 281
Above, ‘Corinth Sheep’ by James Napoli, last year’s Best in Show Winner. Photo courtesy of Gurwin Jewish

Gurwin Jewish Nursing & Rehabilitation Center in Commack invites all amateur photographers, including students, to submit entries for its 25th Annual Photo Contest sponsored by The Tiffen Company of Hauppauge.

Winners of the unique contest have the distinct honor of not only receiving recognition for their work, but the privilege of helping to enhance the lives of the 460 residents that call Gurwin “home,” as winning photographs are permanently displayed in the Center’s renowned Tiffin Gallery and throughout the facility for the enjoyment of residents, staff and visitors.

Nearly 1000 submissions are received each year from across the globe and are judged by a panel of professional photographers who choose the winners based on clarity, composition, subject matter and suitability for display at the Center. Grand prize and honorable mentions, as well as Best-In-Show and Runner-Up winners are selected in each of 12 categories: Landscapes, Travel, People, Pets, Children, Wildlife, Nature, Still Life, Altered/Enhanced, Student, Long Island/New York and Action/Sports. In addition, a panel of Gurwin residents weighs in on their favorites, choosing “Resident Selection” winners from among the entries.

“Our annual Photo Contest is a unique opportunity for our schools, local camera clubs and other members of the community to touch the lives of our residents,” said Stuart B. Almer, Gurwin’s President and CEO. “Their beautiful photos add a feeling of vibrancy to the facility; both residents and staff are eagerly awaiting this year’s crop of winners.”

Every submission is a “winner” in the sense that those not selected for a prize are repurposed by Gurwin’s staff for programs that benefit the residents. Prints are used as reminiscence aids, for visual stimulation and for art therapy, providing a source of comfort and inspiration, specifically for those residents in the Center’s Memory Care Unit and Adult Day Care Programs.

Winners are selected and notified in May. A reception at the Gurwin Center for winning photographers will be held in June where they will receive their cash prize, award certificate and/or crystal trophy. Deadline for submissions is April 16.

Photographers may submit up to seven printed color or black and white 8×10 or 8×12 photographs for a fee of $5 per entry. Entry forms are available for download online at www.gurwin.org/about/photo-contest or by calling the Gurwin Public Relations office at 631-715-2568.

Prev1...803804805...969Next Page 804 of 969
TBR News Media is your local news and entertainment website.
We provide you with the latest breaking news and information for your community.
Contact us: [email protected]

Most Viewed

©